Management and characteristics of patients suffering from Clostridiodes difficile infection in primary care.
Eur J Gen Pract
; 27(1): 320-325, 2021 Dec.
Article
em En
| MEDLINE
| ID: mdl-34755587
ABSTRACT
BACKGROUND:
Clostridioides difficile infection (CDI) is rising and increases patient healthcare costs due to extended hospitalisation, tests and medications. Management of CDI in French primary care is poorly reported.OBJECTIVES:
To characterise patients suffering from CDI, managed in primary care and describe their clinical outcomes.METHODS:
Retrospective observational study based on survey data among 500 randomly selected General Practitioners (GPs) surveyed in France from September 2018 to April 2019. GPs were asked to complete a multiple-choice questionnaire for each reported patient presenting a CDI. Responses were analysed according to clinical characteristics. Treatment strategies were compared according to theoutcome:
recovery or recurrent infection.RESULTS:
Participation rate was 8.6% (n = 43/500) with two incomplete questionnaires. Data from 41 patients with an actual diagnosis of CDI were analysed. Recovery was observed in 61% of patients with a confirmed diagnosis of CDI. In the recovery group, this was exclusively a primary episode, most patients (72%) had no comorbidities, were significantly younger (p = 0.02) than the ones who relapsed and 92% were successfully treated with oral metronidazole. Duration of diarrhoea after antimicrobial treatment initiation was significantly shorter in the recovery group (≤ 48 h) (p = 0.03). Cooperation with hospital specialists was reported in 28% of the recovery group versus 87.5% of the recurrent group (p = 0.0003). Overall, GPs managed successfully 82.9% of cases without need of hospital admission.CONCLUSION:
GPs provide relevant ambulatory care for mild primary episodes of CDI using oral metronidazole. Persistent diarrhoea despite an appropriate anti-Clostridiodes regimen should be interpreted as an early predictor of relapse.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Clostridioides difficile
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Infecções por Clostridium
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Eur J Gen Pract
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
França